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目的:探讨重症肝脓肿患者早期行超声引导下经皮肝穿刺置管引流的价值。方法:选取10例确诊为肝脓肿合并感染性休克患者的病历资料。观察置管时间以及置管前后的体温、白细胞、中性粒细胞比率、CRP、降钙素原、血清乳酸及APACHE变化情况。结果:10例患者均进行经皮肝穿刺置管引流,成功率为100%,未发生严重并发症。穿刺置管距发病时间为2~5 d。置管引流前与引流后1 d、3 d、7 d比较,体温、白细胞、中性粒细胞比率、CRP、降钙素原、血清乳酸及APACHE Ⅱ评分较前明显改善,差异有明显统计学意义(P<0.05)。结论:肝脓肿合并感染性休克进展迅速。抗炎治疗的同时应尽早进行经皮肝穿刺置管引流。
Objective: To investigate the value of ultrasound-guided percutaneous transhepatic catheterization in patients with severe liver abscess. Methods: The clinical data of 10 patients diagnosed as liver abscess combined with septic shock were selected. The duration of catheterization and body temperature, leukocyte, neutrophil ratio, CRP, procalcitonin, serum lactate and APACHE before and after catheterization were observed. Results: All 10 patients underwent percutaneous transhepatic catheterization and drainage with a success rate of 100% without serious complications. Puncture catheter from the onset time of 2 ~ 5 d. Before catheter drainage and 1 d, 3 d, 7 d after drainage, body temperature, leucocyte, neutrophil ratio, CRP, procalcitonin, serum lactate and APACHE Ⅱ score significantly improved compared with the previous, the difference was statistically significant Significance (P <0.05). Conclusions: Liver abscess progressed rapidly with septic shock. Anti-inflammatory treatment should be carried out as soon as possible percutaneous transhepatic catheter drainage.